{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T03:57:26Z","timestamp":1778990246092,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,2,16]],"date-time":"2014-02-16T00:00:00Z","timestamp":1392508800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>People with severe mental illness have a 20\u2010year life\u2010expectancy shortfall. The majority of antipsychotic medications are associated with obesity and heightened diabetes risk. People with severe mental illness less frequently achieve benchmarked diabetes care, often attributed to poor adherence, lower clinical attendance and documented medical biases in treatment. This case is presented to highlight the profound effect medication change can have on diabetes control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case report<\/jats:title><jats:p>A 56\u2010year\u2010old man with a 42\u2010year history of schizophrenia had required clozapine treatment for the preceding 14\u00a0years. Type\u00a02 diabetes and obesity occurred within 4\u00a0years of clozapine instigation. Glycaemic control had been continuously poor, despite frequent contact with diabetes services and multiple medications, including insulin at a dose exceeding 200\u00a0<jats:styled-content style=\"fixed-case\">IU<\/jats:styled-content> daily. Request for consideration of antipsychotic review and close interaction with the psychiatry team was initiated at the diabetes outpatient clinic. A gradual medication switch from clozapine to aripiprazole was associated with a reduction in HbA<jats:sub>1c<\/jats:sub> from 80 to 50\u00a0mmol\/mol (9.5 to 6.7%) over 4\u00a0months, associated with a weight loss of 10\u00a0kg. Over the ensuing 2\u00a0years, the improvement in HbA<jats:sub>1c<\/jats:sub> has endured, with total weight loss of 13\u00a0kg and halving of insulin requirements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case illustrates the benefits of engagement between endocrinologists and psychiatrists to achieve the shared goal of improved physical health in severe mental illness. Greater interdisciplinary collaboration will help bridge the life\u2010expectancy gap in severe mental illness and may assist in preventing disabling diabetes complications in this vulnerable patient group.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.12359","type":"journal-article","created":{"date-parts":[[2013,11,16]],"date-time":"2013-11-16T14:56:45Z","timestamp":1384613805000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The effects of antipsychotic switching on diabetes in chronic schizophrenia"],"prefix":"10.1111","volume":"31","author":[{"given":"R.","family":"Arnoldy","sequence":"first","affiliation":[{"name":"Diabetes and Obesity Program Garvan Institute of Medical Research Darlinghurst NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Curtis","sequence":"additional","affiliation":[{"name":"Eastern Suburbs Mental Health Program, Bondi Centre South Eastern Sydney Local Health District Bondi NSW Australia"},{"name":"School of Psychiatry University of New South Wales Kensington NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Samaras","sequence":"additional","affiliation":[{"name":"Diabetes and Obesity Program Garvan Institute of Medical Research Darlinghurst NSW Australia"},{"name":"Department of Endocrinology St Vincent's Hospital Darlinghurst NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,2,16]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f2969"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674379103600401"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.171.6.502"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.64.10.1123"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.184.47.s67"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.29.04.06.dc05-1261"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.184.47.s64"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.2051-5545.2011.tb00014.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2010.07.012"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2011.156"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291798008186"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.22.2631"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1359786810382058"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2013.2053"},{"key":"e_1_2_7_16_1","article-title":"Diabetes risk potentially underestimated in youth and children receiving antipsychotics","author":"Samaras K","year":"2013","journal-title":"JAMA Psychiatry"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-7893.2011.00315.x"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.12359","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.12359","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.12359","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T03:16:42Z","timestamp":1696303002000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.12359"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,2,16]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2014,3]]}},"alternative-id":["10.1111\/dme.12359"],"URL":"https:\/\/doi.org\/10.1111\/dme.12359","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,2,16]]},"assertion":[{"value":"2013-08-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-11-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-02-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}